The Influence of Social Media Platforms on the Use of E-Cigarettes Among School-Going Youths in Rural Appalachia

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Background: Electronic nicotine products (ENPs) such as e-cigarettes have emerged as the most commonly used tobacco products among middle and high school students in the United States (U.S.). In 2019, almost 1 in 10 and 1 in 4 middle and high school students used e-cigarettes, respectively. Although familial relations and access to ENPs continue to play a major role in the uptake of e-cigarettes among adolescents, little is known about the role of social media in this phenomenon. Therefore, this study aimed to assess the role of social media in the uptake of e-cigarettes among students in Appalachian Tennessee.

Methods: In March 2019, data involving high school students in an Appalachian Regional Commission (ARC)-designated distressed county in Appalachian Tennessee were collected (N=399). We ascertained the study’s outcomes (current e-cigarette use), the exposure (use of social media and the type of social media used to discuss e-cigarette) and covariates using validated questions. Descriptive statistics, bi-variate and multi-variable analyses were performed. The Odds Ratios (ORs), confidence intervals (CI), and the significance level (p ≤ 0.05) have been reported.

Results: About 15.5% of the population were current e-cigarette users, with 9.8% of them ever discussed electronic cigarettes/JUUL on social media, more commonly with snap-chat (8.33%) and Instagram (4.31%). Use of social media (OR = 0.56, CI = 0.37 - 0.83, p = 0.0042) and type of social media used (OR = 0.80, CI = 0.65 - 0.99, p =0.0375) were significantly associated with decreased number of days of e-cigarette use in the last 30 days, after controlling for the covariates.

Conclusion: The use of social media was associated with current e-cigarettes users. As such, there is need for more in-depth examination of social media contents as it relates to ENPs, to understand the mechanism of reduced ENP use among school-going youths in rural Appalachia.

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